How To Improve Your Marketing ROI Without Working 60 Hours/Week
Neil Trickett, PT
Helping Practice Owners Implement Powerful Marketing to Build Their Business
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Does Your Clinic Work For You? (Or is it the other way around?)
Many clinic owners I talk to feel like they're working really hard…but just aren’t seeing the results for that work that they should be. Maybe the clinic seems busy, but with all the challenges of this current healthcare economy money still seems tight and they know results could be better but just feel... okay.
Your clinic DOES deserve to do better than just "okay" – but you shouldn't have to work 60 hours a week to make it happen.
In fact, if you as a practice owner spend too much time working IN your clinic instead of working ON it, the success of your practice will be limited by your time. To really thrive in a way that isn't stressful and overwhelming, the first thing you have to realize is your practice needs you to spend time being the leader. It works for you, you don't work for your practice.
The minute you opened your clinic, you quit being a PT and became an entrepreneur.
Apologies for the cliché, but instead of working harder you need to work smarter.
3 Steps To Improve Marketing Results (and practice growth) Without Overwhelm:
For each of these points, I've provided a brief article below with tips from real practice owners, billing consultants, as well as my team of marketing experts here at Practice Promotions.
Let's jump in, I know you'll find some great tips in this newsletter:
1. How Your Time As An Owner SHOULD Be Spent
From the original article: "The Secret to My Rapid Practice Growth" [Interview with Raj Suppiah, PT]
You Have to Have a Vision
Neil:?What has helped your practice to grow over the last three years?
Raj:?Great question! I think from a vision approach, you have to ask: where do you want your practice to be? Do you want it to be just a clinic, or do you want it to be a brand? For myself and my co-owner Matt, we decided we wanted to take our practice to the next level.?
Neil:?So what did that mean for you??
Stop Treating Patients 40 Hours a Week
Raj:?Well, that meant we could no longer be treating in our practice for the majority of the time. We had to become the leaders and organizers at the top level and create a proper structure. By having specific roles for our employees and having proper organization, we’ve allowed our brand to be more organized.?
But you can’t step out of practicing unless you know you want your brand to be at that next level.?
Raj:?Everyone has a different vision and different goals. If you just want to run a small practice, that’s great, and you don’t have to worry about creating a structure.?But if you want to get bigger, then you have to understand that you can’t be purposeful about marketing if you’re spending 40 hours a week treating patients.?Trying to do both would be very hard, because you’re going to have to spend at least 10 hours a week on marketing, and then a few hours a week managing the marketing team!
You have to be purposeful in how you want to grow and be organized. That’s really been the thing that has helped us grow. We needed to?step back in our roles as treatment providers and step up as leaders.?Leaders that can?create and measure our systems.
Realize You Have to Change Yourself from PT to Leader
Neil:?I couldn’t agree more.?
You have to change as a person in order to take your business to the next level.?And then when you understand you have to change, you ask yourself: what do I have to learn to get there?
Raj:?That’s where you might feel a little uncomfortable. You’re a PT, I’m a PT. We didn’t learn sales. So you have to invest in yourself. You may have to scale back on clinical learning and take some time to get resources to learn about the?business side of things.?
Neil:?I know for me, about 16-18 years ago I realized “Gosh, I need to get better at business.” So now I have 16-18 years of business learning. I pretty much have the equivalent of a Master’s in Business, just not the actual title.?
Raj:?Laughs.?Hey, that counts!?
Neil:?I’m sure you’ve done it too! I’ve spent a lot on my own business training.?But you cannot scale your business–you cannot hit your vision– unless you realize you have to change yourself and get better yourself.
Raj:?So my parting words would be: invest in yourself if you want to grow and know where you want to go.?Know where you’re going, and know where you’re growing.?
Key Takeaways From Step 1:
Raj Suppiah PT is the Co-Founder of?Foundation Physiotherapy & Wellness?in Toronto, ON.
2. Build Systems That Work While You Focus On Other Things
What do I mean by systems?
It's important to note that in your business, "system" sometimes refers to technology but more often refers to a planned, consistent way of doing things that your team is accountable to fulfill and has a specific way to measure results.
As a former practice owner & friend of mine said:
“Automation doesn’t mean high-tech, it means having a clear, repeatable system.”
There are many things vital to your practice's survival and growth, we all know that. But as a practice owner, you can’t spend half of your week working on it. Instead, you need a clearly defined process your entire staff can be trained to fulfill.
The real secret to NOT treating 40 hours a week is setting up systems (or a planned way of doing things) that help your business operate well?without you.?
This means training your employees to do things you normally do yourself OR on things that you need to ensure are done consistently.
This could also mean hiring outside professionals to help with marketing, billing, or HR who can carry out consistent actions each month to help your team internally accomplish more.
Key Takeaways From Step 2:
This won't mean you're completely hands-off with these processes, as an owner you must still oversee the high-level strategy and ensure the team members or outside consultants report the agreed-upon stats to you for accountability. But it will make sure a lot more gets done without you having to push everything yourself.
3. Don't Let Money Fall Out The Bottom!
Billing Can Keep Your Marketing Money Working Its Best.
The most important thing about your marketing budget is that it brings you more money than you put into it by acquiring new patients. But if the patients aren't producing the collections you expect, your ROI will begin to drop and your budget may get wasted even though the patients were there and your clinic felt busy.
I recently interviewed my friend Matt Slimming , a practice owner and billing consultant. Here are his tips to avoid leaving $8,000 on the table each month due to incorrect billing:
From the original article: How To Get The Most Revenue From Your Billing
Biggest Challenge Clinics Face
Neil:?Let’s talk about the industry. A lot has happened in the last decade, especially the last two or three, that have made it difficult for practice owners. We do see practices thriving, I know you help practices thrive in a?challenging economy. Matt, what are some of the biggest challenges that owners face today?
Matt:?There is a lot of pain amongst owners today, it does vary by region with some states suffering more than others, but it’s pretty universal that all are experiencing financial challenges. The big factors of course are?declining reimbursements,?Medicare’s cut?with PTA services was huge and they are really hammering the profit margins. Add in increased expenses and payroll, a lot of owners are struggling. Pay rates have gone up for PTs, support staff, & now is more if required of support staff at the front desk.
领英推荐
Neil:?Yeah, you know it’s about being even better in business today. I would say today, especially in this challenging environment, you need to be able to work smarter, not necessarily harder. Good business practices will prevail and those clinic owners who train, learn, and manage being a better business owner will be ones who will be successful in today’s environment. There is tons of opportunity in our industry, if we’re looking in the right ways.
If we’re willing to think a little outside the box and be smart about how we’re business owners working?on?our business not?in?it.
Matt:?So true. I think there is plenty of opportunity, there is a lot of revenue flowing into the outpatient PT industry, possibly more than previous years since the increased access to PT and referrals. I am having conversations with surgeons who are bemoaning the fact saying “I need to get my patients to physical therapists before I even do an MRI now!” So there are a lot of good things going on that weren’t happening 5-10 years ago.
3 Key Measures to Track
Neil:?You own and operate a large multi-location clinic, what are some of the things that you’ve done to overcome these challenges in your practice?
Matt:?15 years ago it became apparent to me you can’t run a clinic as a hobby. You need to carry out the disciplines of business ownership & management. We have been identifying KPIs that we really measure & adhere to targets to optimize our profitability. This year with the challenges it hasn’t been as big of a deal, we’re recognizing that profits have diminished a bit, but we’re taking steps to address that.
The 3 key things we measure are?timed units per visit, visits per case, and CPT mix ratios. We measure a lot of other things, but if we get those right, we’re doing pretty good. Now we’re saying “okay, it’s not just measuring this for commercial insurers, federal insurers”, we look at flat rate insurers as well and are aware of how we treat those patients. You know, if you’re not being paid for a full hour, is it really responsible to have the patient under the care of a PT for a full hour?
Neil:?I remember when I was running my practice there was a time when I wasn’t as good about understanding billing & those processes. It led to financial strain, but it forced me to take a good look at our billing processes and work hard to improve them. When is the right time to bill and treat patients with different types of insurances? We’re conditioned to provide the best care that we can for everyone regardless of payment, right?
In today’s world, you need to be a little smarter. What is the cost of you running per visit? Your front desk, salaries, rent, broken it down by number of patient visits you could see in your clinic. That helps you make better decisions about the level of revenue you need to generate from a particular patient visit. You might be better off not taking a certain insurance or adjusting how a therapist bills for things.
Matt:?Yeah, I think it is essential that we’re good stewards about our businesses. That means having difficult conversations with payers. I think for the free market to do its thing, we need to have some payers to lose some providers in their areas and realize they need to adjust their payment rates. We have been a bit slow as an industry to take that step and it doesn’t help anyone. The more responsible we ALL are, not just looking for full schedules and if we’re losing money, but if we’re looking for every visit being a profitable visit then we will all be better off with insurers.
Increasing Profitability Through Better Billing Practices
Neil:?You’ve worked with a lot of different clinics on best practices and billing. What are some ways you’ve helped PTs increase their practices profitability?
Matt:?We’re in an industry that changes all the time and our ability as a billing company to guide them in how they should be dealing with these changes is huge. I feel for these PT owners who have 1 or 2 clinics, they don’t have time to do 40 hours of analysis on insurance payers to change treatment protocol or whatever it might be, that’s our role. When we bring a client on to do their billing and revenue cycle management, after a month or two we have a look at their data and from that we can determine how many times unit per visit for commercial, for federal, for flat fee. This is how many visits you get per case on average.
We know what the ideal numbers should be so we take that information and we share that with you. I’ll meet with the PTs over zoom and have the tough conversations to discuss targets. A lot of PTs have been used to billing a certain way, they want to underbill, letting patients discharge too early. We coach the PTs on all of these items to get their KPIs in line. The things we identify amount to a?40% increase in gross revenue– if they did all these things correctly. It varies with regions, some regions the payers don’t allow x number of visits, but that’s the average we see.
Neil:?Wow, 40% that’s tremendous. I had a good friend who said “the most money you will ever lose is the money you never made”. So if your therapists don’t have a schedule and they should be billing certain codes at certain times, but they’re used to billing a certain other way, that’s money left on the table. It comes back to training and education of our team, knowing when to bill at the right time and what to bill. That’s needed more today than ever.
Matt:?It’s not coincidental that Medicare sets their payment rates where they reward the types of treatments that they feel are most beneficial, which is functional, related type training and the more involved physical therapies. If you’re giving high level therapy you should be billing those codes that pay more. It all goes hand in hand, you do a better job with the patients, you end up billing more, they come back for more visits. It does all work, we just help the PTs become aware of that.
Mistakes To Avoid
Neil:?What is the biggest mistake you see happening in insurance and billing?
Matt:?We see a lot of new clients that come to us with their previous accounts receivable not been worked aggressively. Insurance companies play games, borderline illegal, certainly unethical. They will not pay something, a line item for example, for no good reason. You have to call on it every single month. You can’t just call once, you have to call again and again. If you don’t hit every unpaid line item over 30 days every month, that’s your profit margin.
Neil:?What happens to a practice when it doesn’t bring in the revenue it should?
Matt:?Things get scary, right? I empathize greatly with owners who often come to us because they’re hurting. They cut things like marketing which is crucial for a clinic, it’s a knee jerk reaction. “I can’t pay for marketing this month!” But that leads to horrible consequences. It’s tough when these practice owners have been going through this for 6 months.
If you’re in the insurance industry, you’re definitely experiencing lower payments, even if you’re doing everything correctly. Don’t wait to analyze your data and to dig into what’s really going on. Make tweaks to improve things because invariably it will get tougher. You don’t want to be in that situation where you have to cut expenses.
Neil:?I think some owners can feel out of control. I’ve been there too, there are just so many things hitting you from different sides. Staffing, revenue, new patients, costs increasing for rent. One thing to understand is you can be in control. You have to have the time to work on your business. If you’re treating patients all day, you can’t manage your business. Sometimes we have to make it happen, but you can’t live like that. As a business owner you have to set time aside to look at your billing & metrics. If you don’t then you’re more out of control.
Matt:?Yeah, it’s not easy for a new clinic owner. He’s probably working 60 hours a week, seeing patients, and doing other things we’ve discussed. There is probably 1-2 years that clinic owners have to endure that as they grow their business. I totally agree, get out of that situation as soon as you can and open some time for you to manage your business. Also, self care. The burnout is real. It’s important to carve out time to stay healthy mentally and physically.
Key Billing Areas To Focus On
Neil:?Absolutely. As you’re working with your clients, what are some key areas you tell practice owners to focus on when it comes to billing?
Matt:?Make sure your therapists know how to use codes to maximize treatment and revenue, then track KPIs to help coach your therapists. If you don’t measure it, it doesn’t get better. Ensure your eligibility verification and authorization department is not making errors that lead to non-payment. Work all of your outstanding accounts receivable over 30 days every month, including every single line item. Lastly, make sure your billing entity isn’t allowing write offs of line items that should be paid.
Neil:?Where do you see most billing mistakes happen? Is it not setting things up correctly in the beginning?
Matt:?For the clients we work with– yes. The errors happen during intake, maybe it’s the wrong subscriber ID or wrong insurance. You could be billing a different insurance that has different rules from the correct insurance which makes it more difficult to get that money. Commonly the authorization isn’t re-upped in time, it just depends.
Neil:?How much money do you think the average PT is leaving on the table because they aren’t billing the way that they should be?
Matt:?Our analysis indicates that PT’s leave an average around $8,000 on the table each month. Over the years it has been drilled into them not to over-bill and now PTs will do everything to avoid even the appearance of over-billing. It’s easy not to see a patient for enough visits and that is a huge factor in that $8,000.
Neil:?Whether it’s a new grad or a seasoned therapist that comes on board with you, they’re bringing their way of billing with them. That may not be in alignment with how you do things in your clinic, I don’t think owners think about that enough. They assume that the billing is being done correctly, when really they’re under-billing. Any part of onboarding done with new therapists in your clinic, how you bill and why should definitely be part of that process.
Matt:?Without a doubt. Every month we recommend reviewing how they’re doing on those metrics. If it’s new for someone, it’s not going to change with one discussion. It could take months of coaching and then they can have questions, it requires some back and forth. I would say an hour a month of training per 1-3 PTs.
Tips To Increase Pay From Insurance
Neil:?What are some of your tips for owners who want to get paid more by insurance?
Matt:?Analyze your payer behaviors to identify areas of opportunity to optimize reimbursement. Optimize your visits per case with a focus of working to optimize the health of your patients. Remember you are fighting against patients’ schedules and their financial responsibility. Lastly, track billing metrics and hold your billing entity accountable
Neil:?If I was a practice owner who had done some internal billing, why would I use an outside billing agency?
Matt:?Most practice owners should be focusing 90% of their time on 3 things:
1. Treating or managing the treatment process to ensure excellence
2. Marketing in their community or directly overseeing the local external and internal marketing processes
3. Working on optimizing their company culture every day.
We feel almost everything else should be done by someone else. To be an excellent billing manager requires years of experience in just that. Most PTs won’t be, so outsource that. Even if you have someone you trust in your clinic doing your billing, how do you really know that they are doing a great job? Just the practice management guidance of a great billing company by far pays for the cost of their service.
How To Boost Your Hiring & Results
Neil:?We know hiring is an issue today, you obviously have the billing side and business consulting. What are some things you’re seeing that could help with hiring therapists?
Matt:?First make sure your existing therapists are hitting KPIs pretty consistently and that you are optimizing your payment by each payer after understanding the payer behaviors. This will probably increase your profit. It may reduce the need for a new PT if you cut some payers or change your patient schedule. If you still need a new PT, your now improved profit margin should allow you to offer competitive compensation, but a significant portion of this should be in monthly bonuses. Consistently host PT students for their clinical placements and work at maintaining those relationships.
Neil:?Matt, you’ve done exceptionally well with Star Physical Therapy and other clinics. We’ve had the fortune of working with you for quite a few years now. For you, what marketing systems and strategies have helped Star Physical Therapy over the years?
Matt:?There are a few things that have been crucial for us. When you have a question about something, where do you go? Google! For us we focus on?website development?and?SEO, you have to show up in the first 5 websites if you can. Not always easy depending on the market, but Practice Promotions helps with that tremendously. Your team works with us on tweaking our SEO to be more competitive in certain areas.
Google Ads, boy... I was trying Google Ads by myself for about a year before I came to you guys. I was spending?so many hours?on managing these ads, I wasn’t exceeding. Your team has the magic science down, the secret sauce, because that’s made a big difference.?Newsletters?have been really helpful, both in print and email. The consistent effort of SEO, website development, newsletters, have all just bumped things up.
If you found this newsletter helpful, please consider subscribing at the top or connect with me personally here: Neil Trickett, PT .
Huge thanks to the experts who contributed to this: Matt Slimming and Raj Suppiah PT .
Here's to your success!
-Neil Trickett
I'm a PT, Former Practice Owner with my wife Amy Trickett, PT , & CEO of Practice Promotions. I would love to help you change more lives!
Helping million dollar practice owners scale up to be more profitable, have more personal time & love life again | CEO | Speaker | Mind Expansion Coach
1 年Anything worth while takes effort getting it off the ground, including marketing. BUT if you're still hustling months and years later working a ton of hours in the practice, you are certainly doing something wrong. Nice work Neil Trickett, PT!